Written by Tamara Holmes
HealthCare Writer
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Aetna Health Insurance Review
Aetna, a subsidiary of CVS Health, remains a major player in the U.S. health insurance landscape—particularly in the employer and Medicare markets.
Coverage AreasAetna provides nationwide employer and Medicare coverage, limited Medicaid, and international plans for expats. It no longer offers ACA plans, affecting members in 17 states.
Plan TypesIncludes employer plans, Medicare Advantage, Medigap, and Part D (via SilverScript®), with no ACA, STM, or student health plans.
Key Takeaways
- Medicare & Employer Focus: Strong Medicare Advantage, Medigap, and employer-sponsored plans nationwide, many with $0 premiums and rich benefits.
- Leaving ACA Market: Exiting all ACA individual and family plans in 2026, affecting over 1 million members who must switch to other insurers.
- Solid but Mixed Experience: Competitive pricing and strong CVS Health integration, but past ACA service complaints and billing issues remain concerns.
2026 Aetna Health Insurance Review
Aetna, a subsidiary of CVS Health, remains a major player in the U.S. health insurance landscape—particularly in the employer and Medicare markets. In 2026, the company is undergoing a substantial strategic shift with its complete exit from the Affordable Care Act (ACA) individual marketplace. While this change will impact over 1 million existing enrollees, Aetna maintains strong positioning in Medicare Advantage and employer-sponsored coverage, backed by CVS Health’s integrated care model and national pharmacy network.
Pros and Cons
Pros
- National Medicare Advantage and Supplement coverage in 44+ states
- Broad availability of employer-sponsored plans nationwide
- Highly rated Medicare Advantage plans, with many $0 premium options
- Extensive supplemental benefits including dental, vision, hearing, and fitness
- Competitive pricing for Medigap plans and strong member wellness offerings
Cons
- Complete exit from the ACA individual and family market starting in 2026
- Limited focus on short-term, student, and supplemental non-Medicare markets
- Above-average complaint index, especially in past ACA and individual coverage
- Mixed consumer reviews about billing transparency and claims communication
Coverage Area (2026)
United States
- ACA Marketplace Plans: Aetna will no longer offer individual or family ACA-compliant plans as of January 1, 2026, following sustained financial losses in that segment. This move affects roughly 1 million members across 17 states.
- Employer-Sponsored Plans: Available nationwide, Aetna continues to offer comprehensive medical coverage for small and large businesses, including HMO, PPO, POS, and EPO plans.
- Medicare Advantage & Supplement: Aetna offers plans in 44 states and D.C., reaching 59 million eligible Medicare beneficiaries. Offerings include MA, Medigap, and Part D prescription coverage.
- Medicaid: Participates in several state Medicaid programs, though the company’s primary focus is on Medicare and employer markets in 2026.
International
Aetna maintains a niche portfolio of international health plans for expatriates and travelers, offered through Aetna International and global affiliates.
Provider Network
Leveraging CVS Health’s infrastructure, Aetna provides extensive in-network access to primary care, specialists, pharmacies, and urgent care services across the U.S.
Plan Types Offered (2026)
Under-65 (Individual & Family)
- ACA Marketplace Plans
Aetna has officially exited the ACA market for 2026. Existing members must transition to other insurers during open enrollment. - Short-Term Medical (STM)
Not emphasized in Aetna’s 2026 strategy. No substantial public updates are available. - Employer-Sponsored Plans
Continued national availability with flexible options. Plan formats include HMO, PPO, EPO, and value-based POS. Preventive care, chronic disease management, and telehealth features are widely available. - Student Health Plans
Not promoted or widely available in 2026. - Medicaid
Operates in selected states, typically under managed care contracts.
Medicare (65+)
- Medicare Advantage (MA)
Includes a wide selection of HMO, PPO, D-SNP, and C-SNP plans, many with $0 premiums. Plans include OTC benefits, SilverSneakers, dental, vision, transportation, and hearing coverage. - Medicare Supplement (Medigap)
Offered in over 40 states. Features include predictable out-of-pocket costs, broad provider access, and optional add-ons for dental and vision. Plan G remains a popular choice. - Part D Prescription Drug Plans (PDP)
Aetna’s PDP offerings have been consolidated into SilverScript® Choice, available nationwide. These plans offer low or $0 premiums for eligible Extra Help recipients. - Retiree Group Medicare
Available to employer and union groups as bundled retiree solutions.
Recent Changes in Cost and Options (2026)
Premiums and Rate Changes
While ACA plans have been discontinued, rate filings for 2025 showed significant pressure on margins—a key factor in Aetna’s market exit. Medigap and Medicare Advantage premiums remain competitive, though they vary regionally.
Out-of-Pocket Costs
MA plans include low or $0 copays for primary care, Tier 1 medications, and routine preventive services. Medigap enrollees benefit from predictable, capped expenses under plans like G and N.
Medicare Advantage Updates
CMS finalized a 2026 increase in MA reimbursement rates, which may help support Aetna’s benefit-rich plans. Read the CMS payment policy.
Plan Enhancements
Plans now include broader transportation coverage for D-SNPs, expanded dental and vision services, wellness credits, and new digital engagement tools for chronic care management and telehealth.
Network Agreements
Aetna benefits from CVS Health’s robust care delivery infrastructure, including in-store clinics and retail pharmacy integration, supporting both MA and employer health services.
A team of licensed insurance agents are here to help you compare plans
Consumer Experience Snapshot
Complaint Index
Aetna’s complaint index remains above average, primarily due to ACA claim disputes and communication issues. With ACA plans now discontinued, future performance may improve in focused segments.
Satisfaction Scores
Reviews for Aetna’s Medicare Advantage plans are generally positive, citing wellness benefits and plan quality. However, customer reviews on platforms reflect frustration among prior ACA members over billing and authorization delays.
Methodology
Our Health Insurance Rating Methodology scores insurers across five main categories, each rated on a scale of 1 to 10. The overall score is the average of: Coverage, Breadth and Accessibility, Plan Variety and Customization, Affordability and Value, Innovation and Care Quality, and Consumer Experience and Transparency.
Categories assess provider reach, plan diversity, cost structure, care delivery, and member service experiences based on public data, filings, and expert analysis.
Bottom Line
Aetna remains a strong performer in the Medicare and employer-sponsored health markets, with high satisfaction among MA members and continued innovation through its CVS Health partnership. However, its withdrawal from the ACA exchange significantly reduces access for under-65 individuals seeking individual coverage in 2026. Customers who previously held Aetna ACA plans must transition during open enrollment.
Best for
- Medicare Advantage and Medigap enrollees
- Employees covered under group health insurance
Not ideal for
Individuals and families seeking ACA marketplace coverage
Thank you for your feedback!
Aetna. “Aetna Company Names.” aetna.com (accessed February 19, 2021).
Aetna “International Health Insurance for Individuals.” aetna.com (accessed February 19, 2021).
Aetna. “Our Corporate Profile.” aetna.com (accessed February 19, 2021).
A.M. Best. “AM Best Affirms Credit Ratings of CVS Health Corporation’s Aetna Subsidiaries.” Press Release December 17, 2020 (accessed February 22, 2021).
CVS Health. “CVS Health Completes Acquisition of Aetna, Marking the Start of Transforming the Consumer Health Experience.” News release, November 28, 2018 (accessed February 19, 2021).
Aetna. “Aetna Membership Facts.” aetna.com (accessed February 19, 2021).
Aetna. “Medical Insurance Plans for Individuals and Families.” aetna.com (accessed February 20, 2021).
Aetna. “Health Insurance Through Work.” aetna.com (accessed February 19, 2021).
Aetna. “Aetna Medicare Advantage Plans.” aetnamedicaresolution.com (accessed February 22, 2021).
Aetna. “Aetna Medicare Solutions.” aetnamedicare.com (accessed February 20, 2021).
Aetna “Medicaid Health Plans.” aetna.com (accessed February 20, 2021).
Aetna “Student Health Insurance.” aetna.com (accessed February 20, 2021).
Aetna “Supplemental Health Insurance Plans.” aetna.com (accessed February 20, 2021).
Aetna. “Lesser Known Health Perks Your Plan May Offer.” aetna.com (accessed February 22, 2021).
Aetna. “Aetna: Part of CVS Health” aetna.com (accessed February 22, 2021).
Aetna. “Aetna Member Services: Contact Options” aetna.com (accessed February 22, 2021).
Aetna. “Get to Know Us, and Grow Your Business.” aetna.com (accessed February 22, 2021).
Aetna. “How to Make a Claim.” aetna.com (accessed February 22, 2021).
Fitch Ratings “Fitch Affirms Aetna’s IFS at ‘A’; Outlook Stable” Press Release May 22, 2020 (accessed February 22, 2021).
National Association of Insurance Commissioners. “Results by Complaint Index: Aetna Health Ins Co.” naic.org (accessed February 22, 2021).
Consumer Affairs. “Aetna Health Insurance.” consumeraffairs.com (accessed February 22, 2021).
